DERMATOPHILE
The many faces of cellulitis
Correspondence to:
Northwestern University Feinberg School of Medicine, Department of Dermatology, 676 N St. Clair, Suite 1600, Chicago, Illinois 60611, USA; p-lio@northwestern.edu
| The first 150 words of the full text of this article appear below. |
Non semper ea sunt quae videntur (Things are not always what they seem)-Phaedrus
Rubor (redness), tumour (swelling), dolor (pain) and calor (heat) represent the four classical signs of inflammation, as described by the Roman physician Celsus in the first century AD.1 When observed in the skin in the acute setting, these signs are often considered synonymous with bacterial cellulitis, a reasonable assumption given the incidence and importance of early treatment of skin and soft tissue infections.2 Unfortunately, an incorrect initial diagnosis of infection can continue to follow the patient, resulting in unnecessary treatments, prolonged discomfort, and delayed diagnosis. In one study, some 13.6% of patients referred to a specialty centre for cellulitis were found to have alternative diagnoses, suggesting that this is not a rare occurrence.3
Many entities may mimic cellulitis and, compounding the confusion, many of these processes may be complicated by secondary or concomitant bacterial infection.3–5 For
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